Growth, Collaboration, and Real-World AI in Orthopedics with Andrew Lovewell of Columbia Orthopaedic Group

In this episode, Andrew Lovewell, CEO of Columbia Orthopaedic Group, shares his perspective on the evolving role of AI in healthcare, market consolidation, and how his organization is expanding services and market share. He discusses the importance of collaboration, practical innovation, and staying grounded in patient-centered, high-value care.

Episode Transcript

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(00:49):
Hello, everyone. This is Franchesca Matthews with the
Becker's ASC review podcast.
I'm thrilled to be joined today by Andrew
Lovewell,
CEO at Columbia Orthopedic Group.
Thank you so much for being here today.
Yeah. Thank you so much. I'm, looking forward
to our discussion today.
Yeah. Excellent.
Just to start off, could you please introduce

(01:09):
yourself and tell us a little bit about
your background?
Yeah. My name's, Andrew Lovewell. I am the
chief executive officer
for Columbia Orthopedic Group.
We're a large MSK
ortho practice in, Columbia, Missouri.
We own a surgery center,
DME pharmacy,

(01:29):
imaging center. Just about anything you could imagine
that touches one of our patients,
we we have a full comprehensive offering,
for all of our patients.
Prior to this role, I actually, worked for
our group currently,
running our surgery center before.
And then I was with an academic,
medical center before that and then with an

(01:49):
academic hospital before that. Been in health care
for
about sixteen years in various different roles, and
it's a complicated,
puzzle that we all get to try to
solve every day. So looking forward to, talking
about some of that stuff.
Absolutely.
Complicated puzzle for sure.
Just to to dive right in here, what
are the top three trends that you're following

(02:11):
in health care and ASCs today?
Yeah. I think, you know, if anybody
comes on the podcast and and doesn't talk
about AI
as a a top three trend,
they might not be reading any of your
guys'
publications.
But AI is a huge one for us.
You know, we're trying to figure out
where does it land,

(02:32):
where is the utility,
How far do we go? You know, do
you start small? Do you go all in?
What elements do you kind of,
kinda start with in your practice? You know,
is it scheduling or pre cert or faxing
or
all those kind of tasks,
oriented things that an AI bot or something
can help with.

(02:54):
You know, past that, I would say the
the payer landscape for me is a a
big one,
dealing with,
commercial contracts and payers and
looking at how
they structure deals and payer policies change the
landscape completely. You know, UnitedHealthcare just came out
and said they're they're cutting their CRNA reimbursement
by 15%
coming up.

(03:15):
Obviously, that's not a shocker for us, but,
you know, it is a now we have
to, you know,
react
to that type of news.
And then I would say outside of that,
past the payer issues, it it's just the
mergers, acquisitions, private equity, all of those things,
trying to keep up with all the transactions
that are occurring out in the marketplace and

(03:37):
being aware of
what,
the trajectory of the health care landscape looks
like. So
there's a lot on our plates, you know,
obviously, as health care leaders today, but,
you guys at Becker's do a great job
with providing information and insight, and that's an
easy way to kick start your day with
some of the articles that are there. They're
quick. They're easy to read, and I think

(03:58):
that
staying informed is is nice,
with your guys' platform.
But, really,
I'd say one of the biggest resources we
all have too is our network of colleagues
and talking to them about all these emerging
things and getting a take on, hey, what
are you trying for AI? What are you
doing? You know, just crowdsourcing some of that
stuff is extremely valuable.

(04:20):
Mhmm. Absolutely. And, you know, always appreciate the
the love for Becker's and all of our
insights and
content come directly from providers like yourself. So
I think definitely what you said there about
that network is, you know, one of the
most valuable tools that folks have and
figuring out the the complicated puzzle of of
health care.
And just to kind of follow-up a little

(04:40):
bit on the AI component, I'm curious. I've
had this conversation with a few folks recently,
but what how do you at your your
practice, how are y'all thinking about AI and
kind of how are you distinguishing
between a meaningful,
implementation and something that is maybe just a
little bit of hype and not something that's
actually gonna be effective?
Well, I think that that's a good question.

(05:00):
You know, like, where we're at with AI
is not where we're going to be, you
know, in six months, a year.
I think that our perspectives today on AI
are very different than than the future perspective
we're going to have.
You know, I think that AI is a
novelty at this point in time.
Maybe I'm a complete idiot for thinking that,

(05:21):
but
we quite really understand
what is AI and what isn't AI. I
think it's become this, like, thrown around buzzword
that we're all very excited to talk about.
We all think there's, like, you know, something
out there. I don't think it's going to
ever replace the human to human interaction that
we have with, you know, patients,
and physicians in in the room. It's just

(05:43):
not gonna happen. So
where we have to get is we have
to supplement or augment,
you know, some of the remedial
task work involved with medicine today so we
can get back to actually treating patients. And
if we can use AI to do that,
you know, that's a game changer. I I
think that

(06:03):
what
we as a medical society or health care,
society have kind of
recognized
is that
there's a lot of work that happens that
is very
it just gets in the way of providing
care. You know, like peer to peers are
one of those things that are just a
significant frustration for clinicians and providers all over

(06:26):
the country.
Dealing with denials and prior auths are a
huge problem. Just sorting through faxes alone is
like just a nightmare. You know, our organization
Mhmm. About 50,000
faxes a month. I can't even believe that
that's a technology we still leverage today.
It's,
it has its utility for sure, AI does.
You know, we just have to figure out

(06:47):
which avenue
you you plug that into.
And then we also have to figure out
how we define what is AI versus what's,
you know, machine learning or large language models
or stuff like that because
not everything is truly AI. And
I think that that's a challenge that,
you know and and it's not a knock

(07:07):
on the vendors, but
if any vendor out there, they pivoted to
AI inside the last two years, they all
got it in their branding and messaging and,
you know, I I don't know that I
saw very many booths up there this year
that didn't have an AI type flare to
them.
Mhmm. Yeah. Definitely. I'm hearing what you're saying
is just echoed with, other

(07:28):
ASC leaders I've talked to. There's kind of
a cautious optimism
for sure there.
And, you know, you mentioned kind of what's
what's exciting. I'm curious, what what are you
most excited about right now in the ASC
space?
Yeah. I think in the ASC space, you
know,
obviously,
I've been on the podcast a few times,
been up there and and talked to Beckers.

(07:49):
You know, the ASC space is it's still
prime for growth. You're gonna continue to see
more
stuff shift to the ASC. You know, I've
CMS put out something where they're talking about
getting rid of the inpatient only list altogether.
Now, I don't know that that's
I have cautious optimism on that as well.
There's some stuff that honestly we shouldn't do

(08:09):
in the ASC.
There's a lot of stuff we can, you
know, because it's safe. You know, I think
years ago, people never thought we'd be doing
anterior lumbar fusions in the ASC.
Well, we do those today in our ASC.
Total joints, another one. You know, Medicare approved
us doing those, and now that,
kind of the barn's out of the horse
there, like, everyone's off to the races doing
that. So

(08:30):
I think for us, it's the continuing evolution
of,
you know, medicine and how technology and innovation
can continue to see us
move more stuff, more cases
into a lower cost, higher value environment.
And what that does for patients, what that
does for, you know, Medicare, what that does

(08:52):
for
self funded employers across The US, that's a
big deal.
I also think you're gonna see extremely
more
effort from health systems and also
private equity firms to get into this ASC
space even more than what we're seeing now.
You know, you're you're seeing

(09:12):
Bain Capital and Surgery Partners, their deal broke
up, but
I don't think that anything there is is
conclusively done until, you know,
something else happens. It's just a matter of
time before we see more
activity in our in the market with ASCs.
It's
they're ripe, you know. We are
by far the

(09:33):
the biggest,
opportunity, I would say, to kind of bend
the cost curve of medicine at this point.
Yeah. Absolutely.
And zooming out a little bit, is there
anything you mentioned, you know, there's some excitement
around AI, but what in health care broadly
speaking are you excited about right now?
You know, I think
I'm kind of a naturally pessimistic person by

(09:55):
nature.
But,
I think the things I get excited about
are,
you know, working with other
people
around how we develop
interdisciplinary
plans to grow. You know, is that through
mergers? Is that through collaborations?
You know, what can we do together instead

(10:17):
of separately?
Because there's a lot of
it's a lot of marketplaces
that are out there where
they're very fragmented and people don't work together.
And I think that that's very detrimental for
not only
patients, but also for your contracts.
I see,
you know, you could look in your guys'
publications or just Google on the Internet the

(10:39):
amount of orthopedic groups in The US that
have merged inside the last ten years.
Like, people are recognizing
that there's strength in numbers and value
in
collaboration. So I see that being,
a continued effort,
from like specialties.
You know, dermatology has done this, opto,
ortho.

(11:00):
It's gonna continue to happen.
That's the thing. One of the most exciting
things we can do is
work with the employers, the people actually paying
the bills
to set
up steerage programs and networks to get
patients to the right place at the right
time at the right dollar.
You know, a lot of self funded employers

(11:22):
that are out there today, they're not gonna
be able to continue to afford health insurance
in the near future. So,
you know, there's this whole concept of these
smaller community health plans that are popping up
and creating these narrow high value networks where
patients can access care at
a very low in like, a a very

(11:42):
low entry point for cost, but a high
value for an outcome. So
I see those continuing to pop up. There's
an one out there now that the OrthoForum
has founded, called the OrthoValue Network that's extremely,
productive. There's a lot of referrals that come
through that that employers are kinda latching on
to because they're seeing, you know, wow. Look

(12:04):
at these private 100 orthopedic groups that are
out here that have formed this,
network to where we can get patients in
at low cost, high value
settings, and it's gonna work. It's absolutely gonna
work.
So I I see those as being the
big ones out there. Just continued collaboration and
effort to
kinda marry business and health care and all

(12:25):
those things together to result in a better
outcome for everyone.
Yeah. Absolutely. You're speaking to a number of,
pertinent issues in health care there. And you
also mentioned growth and thinking about growth. I'm
I'm curious how you and your organization are
thinking about growth over the next twelve months.
Yeah. I think for us, you know, we

(12:46):
we've grown a lot just really in the
last two to three years. You know, our
our energy is mainly spent on a couple
things. One
is continuing to shore up and develop our
ancillaries because that's a significant opportunity for revenue
with inside of our practice.
The second thing there is, gaining market share
in not only our market but adjacent markets.

(13:08):
So,
you know, what does that look like? Does
that is that a a partnership with a
hospital to where we become their orthopedic partner
of choice? Is that a, you know, where
you have orthopedics and and we can help
co manage that? You know, how does that
structure kind of fit with us?
And then, you know, we're not immune to
the other things that are out there in
the marketplace. You know, we've bought a few
practices.

(13:29):
We'll continue to look at things in a
very
realistic perspective. You know, the acquisitions that we've
made, I would say
that, everyone won in those deals. You know,
the physicians that were there now make more
money because they are on our contracts. They're
not managing their practice. You know, we had
one practice we bought where
the doc was paying bills at 02:00 in

(13:51):
the morning and trying to make his payroll
for his employees, you know, and it's and
that just wears on you. You know, you
can't be productive when you're doing something like
that. So,
you know, there's a there's a lot of
opportunity out in the market place, but we
all just have to kinda put the ego
aside and say, okay, what can we do
together? But I think that's the fastest way
we're gonna continue to grow is just being
very,
very real about the process and talk through

(14:13):
all of the elements that are involved and
be transparent and,
you know, just go to work. That's
that's that's our strategy.
Yeah. Absolutely. Doing doing more together is something
we say here at Becker's as well, so
definitely definitely hear you on that one.
And that's actually all I have for you
today, Andrew.
Thank you so much for joining us. It

(14:33):
has been a pleasure speaking with you, and
I look forward to connecting with you again
in the future. Sounds great. Thank you so
much for having me.